And here is the Physician and Surgeon’s Almanac for February 17, 2013.
After his mother died from tuberculosis and his father proved incapable of caring for him and his brother, at the age of twelve, Laënnec went to live with his uncle, the dean of medicine at the University of Nates. In 1800 Laënnec went on to Paris to studying anatomy and dissection with famous physicians such as Guillaume Dupuytren, Gaspard Laurent Bayle, and Jean-Nicolas Corvisart des Marets and after graduating in 1804, Laënnec continued his research as a faculty member of the Society of the School of Medicine in Paris and was appointed personal physician to the half-brother of the French Emperor, Napoleon I.
In 1816, Laënnec was appointed as physician at the Necker Hospital in Paris, where he invented the stethoscope. His new device replaced the long established practice of “immediate auscultation”, in which the physician laid his or her ear directly on the patient to listen to chest sounds. Laënnec’s simple stethoscope design consisted of a hollow tube of wood that transmitted sounds from the patient’s heart and lungs to one ear.
Use of the stethoscope became known as “mediate” auscultation and in 1819 Laënnec published De l’auscultation médiate (“On Mediate Auscultation”), the first work describing heart and lung sounds heard through the stethoscope. Physicians from throughout Europe came to Paris to learn auscultation from Laënnec and the use of his new diagnostic tool. Laënnec wrote the first stethoscope descriptions of pneumonia, bronchiectasis, pleurisy, emphysema, and pneumothorax. A brilliant researcher, beyond auscultation, Laënnec’s was the first to describe micronodular growths on the liver as cirrhosis. In 1804 he used the Greek word melanose, meaning “black”, to describe melanoma, being the first to recognize that melanotic lesions were the result of cancer cells from the original tumor that had spread to other places in the body.
Laënnec was appointed chair and professor of medicine at the College of France, appointed to the French Academy of Medicine and in 1824 he married was made a chevalier of the Legion of Honor. Two years later, at the age of 45 Laënnec, using his stethoscope, diagnosed himself and understand that he was dying from the same disease that killed his mother.
Laënnec’s stethoscope has evolved into the model we use today and became the principal diagnostic tool in medicine and the stethoscope technique revolutionized the diagnosis of cardiac and lung disease.
Here’s a poem by physician and poet Oliver Wendell Holmes, Jr., M.D.
The Stethoscope Song
There was a young man in Boston town,
He bought him a stethoscope nice and new,
All mounted and finished and polished down,
With an ivory cap and a stopper too.
It happened a spider within did crawl,
And spun him a web of ample size,
Wherein there chanced one day to fall
A couple of very imprudent flies.
The first was a bottle-fly, big and blue,
The second was smaller, and thin and long;
So there was a concert between the two,
Like an octave flute and a tavern gong.
Now being from Paris but recently,
This fine young man would show his skill;
And so they gave him, his hand to try,
A hospital patient extremely ill.
Some said that his liver was short of bile,
And some that his heart was over size,
While some kept arguing, all the while,
He was crammed with tubercles up to his eyes.
This fine young man then up stepped he,
And all the doctors made a pause;
Said he, The man must die, you see,
By the fifty-seventh of Louis's laws.
But since the case is a desperate one,
To explore his chest it may be well;
For if he should die and it were not done,
You know the autopsy would not tell.
Then out his stethoscope he took,
And on it placed his curious ear;
Mon Dieu! said he, with a knowing look,
Why, here is a sound that 's mighty queer.
The bourdonnement is very clear,--
Amphoric buzzing, as I'm alive
Five doctors took their turn to hear;
Amphoric buzzing, said all the five.
There's empyema beyond a doubt;
We'll plunge a trocar in his side.
The diagnosis was made out,--
They tapped the patient; so he died.
Now such as hate new-fashioned toys
Began to look extremely glum;
They said that rattles were made for boys,
And vowed that his buzzing was all a hum.
There was an old lady had long been sick,
And what was the matter none did know
Her pulse was slow, though her tongue was quick;
To her this knowing youth must go.
So there the nice old lady sat,
With phials and boxes all in a row;
She asked the young doctor what he was at,
To thump her and tumble her ruffles so.
Now, when the stethoscope came out,
The flies began to buzz and whiz
Oh ho! the matter is clear, no doubt;
An aneurism there plainly is.
The bruit de rape and the bruit de scie
And the bruit de diable are all combined;
How happy Bouillaud would be,
If he a case like this could find!
Now, when the neighboring doctors found
A case so rare had been descried,
They every day her ribs did pound
In squads of twenty; so she died.
Then six young damsels, slight and frail,
Received this kind young doctor's cares;
They all were getting slim and pale,
And short of breath on mounting stairs.
They all made rhymes with "sighs" and "skies,"
And loathed their puddings and buttered rolls,
And dieted, much to their friends' surprise,
On pickles and pencils and chalk and coals.
So fast their little hearts did bound,
The frightened insects buzzed the more;
So over all their chests he found
The rale sifflant and the rale sonore.
He shook his head. There's grave disease,--
I greatly fear you all must die;
A slight post-mortem, if you please,
Surviving friends would gratify.
The six young damsels wept aloud,
Which so prevailed on six young men
That each his honest love avowed,
Whereat they all got well again.
This poor young man was all aghast;
The price of stethoscopes came down;
And so he was reduced at last
To practise in a country town.
The doctors being very sore,
A stethoscope they did devise
That had a rammer to clear the bore,
With a knob at the end to kill the flies.
Now use your ears, all you that can,
But don't forget to mind your eyes,
Or you may be cheated, like this young man,
By a couple of silly, abnormal flies.